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膳食植物化学物质作为自闭症谱系障碍的神经治疗剂:合理机制与证据

Dietary Phytochemicals as Neurotherapeutics for Autism Spectrum Disorder: Plausible Mechanism and Evidence.

作者信息

Bhandari Ranjana, Paliwal Jyoti K, Kuhad Anurag

机构信息

Pharmacology Research Laboratory, University Institute of Pharmaceutical Sciences, UGC-Centre of Advanced Study, Panjab University, Chandigarh, India.

出版信息

Adv Neurobiol. 2020;24:615-646. doi: 10.1007/978-3-030-30402-7_23.

Abstract

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder with symptoms ranging from lack of social interaction and communication deficits to rigid, repetitive, and stereotypic behavior. It has also been associated with comorbidities such as anxiety, aggression, epilepsy, deficit in sensory processing, as well as ADHD (attention deficit hyperactivity disorder). Apart from several behavioral and cognitive complications arising as a result of central nervous system dysfunction, there are various physiological comorbidities such as immune system deregulation, neuroinflammation, oxidative stress, mitochondrial dysfunction, and gastrointestinal complications which can worsen existing behavioral complications. There are no available treatments for these physiological comorbidities. The prevalence of gastrointestinal complications in ASD ranges from 9% to 70% and it correlates with behaviors consistent with the autistic endophenotype indicating that these are one of the major comorbidities associated with ASD. A strong connection of gut-brain cross talk occurs as a result of gut dysbiosis responsible for excessive production of short-chain fatty acids such as propanoic acid (PPA) by abnormal gut flora in ASD patients. This worsens behavioral, neurochemical, and mitochondrial dysfunction occurring in ASD. These physiological comorbidities are responsible for the generation of free radical species that cause immune system dysfunction leading to synthesis of various pro-inflammatory cytokines and chemokines. This in turn causes activation of microglia. Dietary phytochemicals are thought to be safer and useful as an alternative neurotherapeutic moiety. These compounds provide neuroprotection by modulating signaling pathways such as Nrf2, NF-κB, MAPK pathway or Sirtuin-FoxO pathway. There has been recent evidence in scientific literature regarding the modulation of gut-brain cross talk responsible for behavioral, biochemical, and mitochondrial dysfunction as well as cellular and behavioral sensory alterations by dietary phytochemicals such as curcumin, resveratrol, naringenin, and sulforaphane. These dietary phytochemicals can be formulated in novel brain-targeted delivery systems which overcome their limitation of low oral bioavailability and short half-life leading to prolonged action. Till date, not much work has been done on the development of brain-targeted neurotherapeutics for ASD. In this chapter we discuss plausible mechanisms and evidence from our own and other scientific research for the utilization of curcumin, resveratrol, naringenin, and sulforaphane as neurotherapeutics for ASD.

摘要

自闭症谱系障碍(ASD)是一种复杂的神经发育障碍,其症状包括社交互动缺乏、沟通缺陷,以及刻板、重复和定型行为。它还与焦虑、攻击行为、癫痫、感觉处理缺陷以及注意力缺陷多动障碍(ADHD)等共病有关。除了由于中枢神经系统功能障碍而产生的一些行为和认知并发症外,还存在各种生理共病,如免疫系统失调、神经炎症、氧化应激、线粒体功能障碍以及胃肠道并发症,这些都会使现有的行为并发症恶化。目前尚无针对这些生理共病的治疗方法。ASD中胃肠道并发症的发生率在9%至70%之间,并且与自闭症内表型一致的行为相关,这表明这些是与ASD相关的主要共病之一。由于肠道菌群失调,ASD患者肠道中异常的肠道菌群会过度产生短链脂肪酸,如丙酸(PPA),从而导致肠道与大脑之间产生强烈的相互作用。这会使ASD中出现的行为、神经化学和线粒体功能障碍恶化。这些生理共病会产生自由基,导致免疫系统功能障碍,进而合成各种促炎细胞因子和趋化因子。这反过来又会激活小胶质细胞。膳食植物化学物质被认为是更安全且有用的替代神经治疗成分。这些化合物通过调节Nrf2、NF-κB、丝裂原活化蛋白激酶(MAPK)途径或沉默调节蛋白-叉头框蛋白O(Sirtuin-FoxO)途径等信号通路来提供神经保护。最近科学文献中有证据表明,姜黄素、白藜芦醇、柚皮素和萝卜硫素等膳食植物化学物质可以调节肠道与大脑之间的相互作用,从而改善行为、生化和线粒体功能障碍以及细胞和行为感觉改变。这些膳食植物化学物质可以被制成新型的脑靶向递送系统,克服其口服生物利用度低和半衰期短的局限性,从而延长作用时间。迄今为止,针对ASD的脑靶向神经治疗药物的研发工作做得还不多。在本章中,我们将讨论利用姜黄素、白藜芦醇、柚皮素和萝卜硫素作为ASD神经治疗药物的合理机制以及来自我们自己和其他科学研究的证据。

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