Am J Respir Crit Care:新方法可有效治疗睡眠呼吸困难

2018-12-18 编译:赵熙熙 科学网

美国科学家日前进行的一项研究显示,一种广为人知的可调节饥饿和体重的激素,可通过鼻腔给药的方式缓解睡眠过程中出现的呼吸问题。

美国科学家日前进行的一项研究显示,一种广为人知的可调节饥饿和体重的激素,可通过鼻腔给药的方式缓解睡眠过程中出现的呼吸问题。

研究人员表示,他们成功通过实验动物鼻腔给予药物,这可能有助于为患有睡眠呼吸困难的患者(例如睡眠呼吸暂停综合征)开发更易于使用的疗法。

该研究结果发表在《美国呼吸与重症监护医学杂志》网络版上。

1994年首次被发现的瘦素是一种由脂肪细胞生成的激素,主要作用于大脑的食欲中心,可帮助调节食欲。约翰斯·霍普金斯大学医学院Vsevolod Y Polotsky表示:“瘦素治疗肥胖/抑制暴饮暴食的效果并未在人体实验中得到证实,但它对呼吸系统的作用却带来了新的治疗可能性。”

Polotsky的研究重点是寻找治疗阻塞性睡眠呼吸暂停的新策略,这是一种可能致命的严重疾病,影响着约30%的美国成年人。肥胖人群的患病率高达50%。这种疾病的原因是病人在睡眠过程中上呼吸道关闭,导致呼吸停止,结果造成缺氧。肥胖症患者也常常出现另一种被称为肥胖通气不足综合征的健康问题,其通常也伴随着睡眠呼吸暂停。

目前对这些睡眠问题最常见的有效治疗方法是定期佩戴持续气道正压通气(CPAP)面罩和机器,通过机械力量增加喉咙中的气压,确保在睡眠过程中保持呼吸道通畅。但有的患者感觉CPAP机器比较笨重,佩戴不舒服,会发出噪音,同时活动受限制,因此会停止使用。

Polotsky说,以往的研究表明,瘦素对调节呼吸非常重要,可以成功治疗瘦素缺乏肥胖小鼠的睡眠呼吸紊乱症状。但因饮食产生肥胖的小鼠对瘦素具有抗性,将瘦素注射到它们腹部时并没有反应。

Polotsky实验室的博士后研究员Slava Berger说:“导致瘦素抗性的一个主要原因是注射方式摄入的激素,难以穿过血脑屏障进入目标脑细胞。”

为了验证这个想法,研究人员首先对成年雄性小鼠进行了16周高脂肪饲养,使其出现肥胖。由于瘦素从长期来看会导致体重减轻,而减重也会减少呼吸问题,为此研究人员首先评估了在产生减肥效果前,单剂量瘦素对睡眠呼吸的直接影响。

研究人员通过温度变化和小鼠睡眠期间出现氧气不足的次数测量了小鼠吸入空气的量。他们在小鼠脖子上安装项圈观察血氧水平,类似于在紧急护理环境中在人手指上用夹子测量血氧水平。结果显示,只有通过鼻腔进行瘦素给药的小鼠,在睡眠期间通气量增加超过40%,减轻了上呼吸道阻塞的问题,并使小鼠出现氧气水平不足的次数减少了一半以上。

研究人员对鼻腔给药小鼠的大脑神经元进行了染色,发现神经元表面的瘦素受体结合有可检测到的瘦素,这意味着这种给药方法已绕过血脑屏障,将瘦素直接转运到大脑,避免出现瘦素抗性。

为了进一步研究瘦素治疗的长期代谢效应,研究人员对这些肥胖小鼠中的一部分,通过鼻腔或腹部瘦素给药,并持续两周。结果仍然显示,只有通过鼻腔进行瘦素给药的小鼠,才表现出食物摄入减少和体重减轻的结果。这些小鼠体重减轻了1克,几乎占总体重的3%;腹部注射瘦素的小鼠体重却出现超过3克的增加,表明存在瘦素抗性。

Polotsky说:“我们相信,这项研究是通过瘦素鼻腔给药减轻睡眠呼吸障碍的首例证据。我们计划进一步研究通过鼻腔给小鼠施用不同剂量瘦素的效果。”

“能够确认调节呼吸的关键分子,并且理解如何运用这些分子治疗包括睡眠呼吸暂停综合征在内的疾病是一项重大成就。”美国国立卫生研究院下属国家心肺血液研究所国家睡眠障碍研究中心主任Michael Twery评论说,“这项发现为发展新的疗法创造了条件。”

成本也是这种疗法的考虑因素之一。CPAP设备的平均成本为500~3000美元。而Polotsky和Berger估计,如果鼻腔瘦素给药在临床上安全有效,那么它的成本可能类似于吸入胰岛素,每瓶只需25美元左右。

原始出处:
Slava Berger,  Huy Pho, Thomaz Fleury-Curado, et al. Intranasal Leptin Relieves Sleep Disordered Breathing in Mice with Diet Induced Obesity. American Journal of Respiratory and Critical Care Medicine. Oct 2018.

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1903353, encodeId=6f001903353d1, content=<a href='/topic/show?id=e1b0583884b' target=_blank style='color:#2F92EE;'>#新方法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58388, encryptionId=e1b0583884b, topicName=新方法)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c22f171, createdName=kord1982, createdTime=Wed Feb 27 13:13:00 CST 2019, time=2019-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1989114, encodeId=5e621989114f5, content=<a href='/topic/show?id=246ee29858f' target=_blank style='color:#2F92EE;'>#睡眠呼吸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72985, encryptionId=246ee29858f, topicName=睡眠呼吸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3138208, createdName=zhanfl, createdTime=Mon Jun 24 19:13:00 CST 2019, time=2019-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281871, encodeId=be0e12818e123, content=<a href='/topic/show?id=21753963364' target=_blank style='color:#2F92EE;'>#呼吸困难#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39633, encryptionId=21753963364, topicName=呼吸困难)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Thu Dec 20 13:13:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1619531, encodeId=657d161953126, content=<a href='/topic/show?id=8dd46061824' target=_blank style='color:#2F92EE;'>#有效治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60618, encryptionId=8dd46061824, topicName=有效治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Thu Dec 20 13:13:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=355780, encodeId=a66d355e806c, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Tue Dec 18 22:51:01 CST 2018, time=2018-12-18, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1903353, encodeId=6f001903353d1, content=<a href='/topic/show?id=e1b0583884b' target=_blank style='color:#2F92EE;'>#新方法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58388, encryptionId=e1b0583884b, topicName=新方法)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c22f171, createdName=kord1982, createdTime=Wed Feb 27 13:13:00 CST 2019, time=2019-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1989114, encodeId=5e621989114f5, content=<a href='/topic/show?id=246ee29858f' target=_blank style='color:#2F92EE;'>#睡眠呼吸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72985, encryptionId=246ee29858f, topicName=睡眠呼吸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3138208, createdName=zhanfl, createdTime=Mon Jun 24 19:13:00 CST 2019, time=2019-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281871, encodeId=be0e12818e123, content=<a href='/topic/show?id=21753963364' target=_blank style='color:#2F92EE;'>#呼吸困难#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39633, encryptionId=21753963364, topicName=呼吸困难)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Thu Dec 20 13:13:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1619531, encodeId=657d161953126, content=<a href='/topic/show?id=8dd46061824' target=_blank style='color:#2F92EE;'>#有效治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60618, encryptionId=8dd46061824, topicName=有效治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Thu Dec 20 13:13:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=355780, encodeId=a66d355e806c, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Tue Dec 18 22:51:01 CST 2018, time=2018-12-18, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1903353, encodeId=6f001903353d1, content=<a href='/topic/show?id=e1b0583884b' target=_blank style='color:#2F92EE;'>#新方法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58388, encryptionId=e1b0583884b, topicName=新方法)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c22f171, createdName=kord1982, createdTime=Wed Feb 27 13:13:00 CST 2019, time=2019-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1989114, encodeId=5e621989114f5, content=<a href='/topic/show?id=246ee29858f' target=_blank style='color:#2F92EE;'>#睡眠呼吸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72985, encryptionId=246ee29858f, topicName=睡眠呼吸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3138208, createdName=zhanfl, createdTime=Mon Jun 24 19:13:00 CST 2019, time=2019-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281871, encodeId=be0e12818e123, content=<a href='/topic/show?id=21753963364' target=_blank style='color:#2F92EE;'>#呼吸困难#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39633, encryptionId=21753963364, topicName=呼吸困难)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Thu Dec 20 13:13:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1619531, encodeId=657d161953126, content=<a href='/topic/show?id=8dd46061824' target=_blank style='color:#2F92EE;'>#有效治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60618, encryptionId=8dd46061824, topicName=有效治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Thu Dec 20 13:13:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=355780, encodeId=a66d355e806c, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Tue Dec 18 22:51:01 CST 2018, time=2018-12-18, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1903353, encodeId=6f001903353d1, content=<a href='/topic/show?id=e1b0583884b' target=_blank style='color:#2F92EE;'>#新方法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58388, encryptionId=e1b0583884b, topicName=新方法)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c22f171, createdName=kord1982, createdTime=Wed Feb 27 13:13:00 CST 2019, time=2019-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1989114, encodeId=5e621989114f5, content=<a href='/topic/show?id=246ee29858f' target=_blank style='color:#2F92EE;'>#睡眠呼吸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72985, encryptionId=246ee29858f, topicName=睡眠呼吸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3138208, createdName=zhanfl, createdTime=Mon Jun 24 19:13:00 CST 2019, time=2019-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281871, encodeId=be0e12818e123, content=<a href='/topic/show?id=21753963364' target=_blank style='color:#2F92EE;'>#呼吸困难#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39633, encryptionId=21753963364, topicName=呼吸困难)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Thu Dec 20 13:13:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1619531, encodeId=657d161953126, content=<a href='/topic/show?id=8dd46061824' target=_blank style='color:#2F92EE;'>#有效治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60618, encryptionId=8dd46061824, topicName=有效治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Thu Dec 20 13:13:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=355780, encodeId=a66d355e806c, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Tue Dec 18 22:51:01 CST 2018, time=2018-12-18, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1903353, encodeId=6f001903353d1, content=<a href='/topic/show?id=e1b0583884b' target=_blank style='color:#2F92EE;'>#新方法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58388, encryptionId=e1b0583884b, topicName=新方法)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c22f171, createdName=kord1982, createdTime=Wed Feb 27 13:13:00 CST 2019, time=2019-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1989114, encodeId=5e621989114f5, content=<a href='/topic/show?id=246ee29858f' target=_blank style='color:#2F92EE;'>#睡眠呼吸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72985, encryptionId=246ee29858f, topicName=睡眠呼吸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3138208, createdName=zhanfl, createdTime=Mon Jun 24 19:13:00 CST 2019, time=2019-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281871, encodeId=be0e12818e123, content=<a href='/topic/show?id=21753963364' target=_blank style='color:#2F92EE;'>#呼吸困难#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39633, encryptionId=21753963364, topicName=呼吸困难)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Thu Dec 20 13:13:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1619531, encodeId=657d161953126, content=<a href='/topic/show?id=8dd46061824' target=_blank style='color:#2F92EE;'>#有效治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60618, encryptionId=8dd46061824, topicName=有效治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Thu Dec 20 13:13:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=355780, encodeId=a66d355e806c, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Tue Dec 18 22:51:01 CST 2018, time=2018-12-18, status=1, ipAttribution=)]
    2018-12-18 医者仁心5538

    学习了

    0