close
DIABETES

“Nature” inventory: 5 major advances in the endocrine year!

no thumb

Not long ago, this year’s inventory also arrived on schedule, and talked about the five major topics of motor metabolism, islet biology, neuroendocrinology, thyroid cancer and personalized treatment of metabolic diseases … Now, let’s follow the steps of the top issue and seeWhat are the five major advances in the endocrine field in the previous year?We can only stay at home and cannot go out to add chaos to the epidemic prevention work. Let’s read more documents and prepare for Paper next year!1 Exercise Metabolism 2019: The relationship between exercise and metabolism is so complicated!Keypoint “The mechanism is hard to find, the intestinal flora!” It sounds like a metaphysics, but in 2019, the intestinal flora does have important relevant results, one of which is the regulation of intestinal flora by exercise.effect.Some recent studies have discovered the biological connection between skeletal muscle and intestinal flora, explaining the role of intestinal flora in the body’s response to sports challenges, energy supply, muscle function and physical endurance. The study found that:? Diet causedChanges in the composition of the intestinal flora will significantly affect systemic metabolism, energy supply and athletic ability;? Mice with damaged intestinal flora have reduced endurance on the treadmill, impaired skeletal muscle contraction, and restore the intestine byBacterial flora can reverse these performances;? Increased intestinal microbial diversity and rich bacterial species of athletes are related to improved metabolic health and athletic performance;? Veillonella atypica can be isolated from human feces after vigorous exercise, this bacteria can significantlyIncrease the endurance of running in mice.These studies, published in 2019, have further revealed the link between intestinal flora and skeletal muscle.Intestinal microbiota imbalance reduces biodiversity, affects microbial metabolism, and functions of several peripheral organs, but exercise can effectively improve this state, can reconstruct the composition of the intestinal microbiota and restore the symbiotic state of the intestine.At the same time, changes in the intestinal flora caused by exercise can in turn regulate the biological functions of skeletal muscle.Although the exact mechanism of the interaction between intestinal flora, energy storage and skeletal muscle function remains to be studied, there is indeed a two-way highway between the intestinal flora and skeletal muscle!While introducing the relationship between exercise and gut microbes, this column also recommends a review “Exercise and Muscle-Brain Communication”.The review points out that exercise has many beneficial effects on the brain, helps reduce the risk of cognitive impairment, depression and stress, helps restore and maintain cognitive function, and controls metabolism.Studies have shown that there is a direct connection between muscle and brain functions. For example, actin cathepsin B secreted by muscles can cross the blood-brain barrier and enhance the production of brain-derived neurotrophic factors, thereby improving neurogenicity, memory andLearning function.At the same time, exercise can also increase FNDC5 neuron gene expression and increase brain-derived neurotrophic factor levels.Exercise can suppress eating from the center mediated by interleukin-6 (IL-6), and it can also reduce depression symptoms mediated by tyrosine aminotransferase.Actin signaling, other muscle factors, and exercise-related liver factors and adipokines are also involved in neural development, cognitive function, appetite, and metabolism, which not only indicates the existence of the endocrine circuit of the muscle brain, but also confirms the true role of exercise and metabolism.Are inseparable.2 Islet Biology 2019: Is there something in the islets?What’s in Keypoint islets?The most famous is of course the β-cells that produce insulin, but besides this cell, there are actually cells such as glucagon-producing α cells and somatostatin-producing δ cells in the islets.With our efforts, our blood sugar can be kept stable.Because islets are endocrine micro-organs embedded in the pancreas, previous research has often been limited by their location, but with the advancement of technology, new breakthroughs in islet biology research in 2019 include:? Somatostatin secretionThe delta cells can directly contact the capillaries and other hormone cells in the islets through exercise or filamentous pseudopods; Imaging cell counting technology for pancreatic islet tissue in young adults who have just appeared type 1 diabetes effectively uses this rareTissues that reveal the progression of type 1 diabetes and support the view that the glucagon-producing alpha cells have plasticity;? Studies on imaging cell counting techniques for pancreatic islet tissue in young adults who have just developed type 1 diabetes also suggest that type 1 diabetesThe progression of diabetes is related to changes in the β-cell phenotype. By recruiting CD8 + and CD4 + T cells, β-cells can be destroyed. In the NOD mouse model of type 1 diabetes, aging β-cells gradually accumulate during the pre-diabetes phase and further promote immunity.Destruction, selective removal of these cells may prevent the development of type 1 diabetes;Insulin resistance or a high-fat diet mouse model found that metabolic stress can accelerate the aging of β cells, and the increase in the proportion of aging β cells in the elderly and patients with type 2 diabetes, these aging β cells gradually lost βCell characteristics and functions.The achievements of islet biology research in 2019 mainly focus on the adaptation of pancreatic beta cells to environmental changes, but more research is needed on Langerhans cells in the islets and their relationship with the progression of diabetes.The role of macrophages in obesity-related islet inflammation and beta cell abnormalities deserves attention.A recommended review also points to chronic tissue inflammation in obesity, type 2 diabetes, and other insulin resistance.At present, many studies have focused on liver inflammation related to fat accumulation, but fat may also cause inflammation in islets.Unlike T cells in type 1 diabetes, macrophages cause inflammation in obese and type 2 diabetes patients.Local abnormal proliferation of macrophages can generate signals that drive β-cell proliferation, and at the same time impair β-cells’ ability to secrete insulin, eventually leading to insulin resistance.Research on this mechanism may help develop drugs that target islet inflammation, thereby improving beta cell function and blood glucose.3 Neuroendocrinology 2019: Emotions, circadian rhythms, food, eating too hard!Keypoint is the Spring Festival again, how can I hold myself in the face of so many foods?Human eating behavior is regulated by neural pathways and circulatory factors to maintain balance, but it is also affected by emotions.A 2019 study found complex interactions between these balancing mechanisms and hedonic control: • Neuropeptide Y expressed in central amygdala (CeA) neurons has a tendency to eat under chronic stress conditionsAn important driving role, when people can access foods with high energy density, the development of obesity is like fast horses and whip;? Delicious foods can enhance the activity of the central amygdala preganglion progenitor neurons, by changing the terminal lines (stria terminalis), Parabrachial nucleus, and nucleus of the solitary tract, resulting in increased reward characteristics; pro-opiomelanocortin in arcuate nucleusNeurons can be activated by chronic stress and are associated with increased feeding and decreased depression-like behavior mediated by ventral tegmental area; aversion in the posterior island visceral insular cortex and other in vivo stabilizationFunctional integration and subsequent changes in feeding behavior through nucleus accumbensAt the same time changing the anxiety associated with contact by the amygdala (amygdala).These inexplicable nouns and the results of a study that reads baldness partly reveal the decision-making network that the body gradually produces in the process of adapting to the environment.Over the past year, this network has added new members such as the amygdala and insular cortex. These structures interact with the classic hypothalamus and hindbrain structures consisting of pontine, cerebellum, and medulla oblongata, helping in conflicting complex situationsThe body identifies the most urgent needs and acts accordingly.However, the exploration of this field is far from over, and it is expected to produce more exciting results in the future.Circadian rhythm is another major factor affecting diet. A review in 2019 also specifically discussed the connection between the two.The review points out that the most important “clock” for controlling circadian rhythms is in the suprachiasmatic nuclei of the hypothalamus, while the parts of the hypothalamus and brainstem are secondary “clocks”.Metabolic hormones, nutrients in the blood circulation and visceral nerves provide clues to these clocks, allowing the brain and peripheral organs to synchronize at the time of eating.Breaking the rhythm and eating irregularly can cause adverse effects on metabolism, and regular meals can reduce metabolic disorders.4 Thyroid Cancer 2019: Learn how to follow up in this article, and make new breakthroughs in treatment!Keypoint multikinase inhibitors are effective treatments for thyroid cancer, and the main drug target is related to angiogenesis.In addition, the 2019 study used drugs targeting RET and BRAF to treat medullary thyroid cancer and anaplastic thyroid cancer.However, the genome of thyroid Hürthle cell carcinoma is unique and lacks specific mutations that drive cancer development, making it difficult to treat with targeted drugs.Many breakthroughs in the treatment of thyroid cancer over the past year:? The combination of the BRAF inhibitor dabrafenib and the MEK inhibitor trametinib has a long-lasting response in patients with anaplastic thyroid cancer with a BRAFV600E mutation,Provides treatment for this most aggressive thyroid cancer; Two new selective RET inhibitors BLU-667 and LOXO-292 in patients with medullary thyroid carcinoma with RET mutations and RET fusion papillary thyroid carcinomaIt has shown anti-tumor effects and good safety at the same time; Hürthle cell carcinoma is a unique tumor with mitochondrial dysfunction and extensive loss of heterozygosity.Although the effects of selective kinase inhibitors on BRAF-driven and RET-driven thyroid cancer are promising, it is necessary to conduct research to compare the differences between these treatments and the current standard treatments to determine whether these treatments can provide patients with survival benefits.At the same time, careful research on the mechanism of drug treatment will help avoid drug resistance.Compared with these thyroid cancers that require kinase inhibitors, some differentiated thyroid cancers are much milder and can even be treated with active follow-up.There have been previous reviews on this topic, which we have already introduced.This review points out that the development of a follow-up plan for thyroid cancer needs to be determined by factors such as the stage of thyroid cancer, the risk of recurrence, response to treatment, tissue type, and molecular type.During the follow-up process, laboratory thyroid function tests, neck ultrasound and cytology tests, whole-body radioactive iodine scans, and multiple imaging methods can be used to arrange and combine them to formulate a corresponding follow-up plan according to the risk of recurrence of the patient.In addition, the follow-up plan should be adjusted at any time according to regional conditions, clinician and patient preferences.5 Personalized Therapy for Metabolic Diseases 2019: Beginning with diabetes, but not only for diabetes Keypoint Type 2 diabetes personalized or precise treatment has gradually become a reality as people continue to understand their subtypes, future type 2 diabetes treatmentsIt is necessary to comprehensively consider the patient’s genetic background, environmental factors, clinical measures, lifestyle, cost-effectiveness, and treatment burden, and pay attention to the differences between different subgroups and even different individuals.Taking advantage of the heterogeneity of patients with type 2 diabetes, patients’ treatment is progressing:? The results of the subgroup analysis divided patients with type 2 diabetes into at least five types. These different types of diabetes patients have genetics, insulin secretion, disease progression, and complications.There are significant differences;? Convenient, measurable continuous clinical phenotypes can help predict a patient’s disease progression, such as fatty liver or neuropathy;? Autoimmune screening may be beneficial for all patients with type 2 diabetes;Increased acceptance of diet and exercise patterns, in-depth longitudinal omics analysis, or predictive models of insulin resistance may be established;? Compared with sulfonylureas, patients with insulin resistance may benefit from PPARγ agonist targeted therapy, protectionCardiovascular; • Models of multi-criteria decision analysis including disease outcomes, patient preferences, and drug characteristics can improve personalized treatment of type 2 diabetes.The personalized treatment of type 2 diabetes has only just begun. We try to combine physiology, omics, behavior and component benefit analysis to accurately apply to the precise treatment of patients with type 2 diabetes..The authors point out that the combination of simple clinical detection methods, omics data, and patient-centric methods will promote personalized prevention and treatment of all different types of type 2 diabetes.Type 2 diabetes is not a separate disease. Obesity, type 2 diabetes, and cardiovascular disease together pose increasingly serious challenges to global public health and the economy.The current treatments for these metabolic disorders may have little effect on most patients and will not reduce the prevalence of these diseases.The review states that as the mechanisms behind states such as dietary behavior, energy expenditure, dyslipidemia, and insulin resistance are gradually revealed, suggesting that therapies that target multiple signaling pathways may be required to reverse these diseases.Several peptidic or peptide-small molecule conjugates multipotent agonists have emerged for therapeutic use.These emerging drugs may be able to act on multiple therapeutic targets for metabolic diseases simultaneously, ultimately changing current treatments.The above content is only authorized for exclusive use by 39Health.com, please do not reprint without the authorization of the copyright party..

ouyangshaoxia

The author ouyangshaoxia