随着中国医学界对于肿瘤相关性贫血（cancer related anemia,CRA）的逐渐重视,《肿瘤相关性贫血临床实践指南》也于今年更新到2015—2016版。从2011—2012版的《肿瘤相关性贫血临床实践中国专家共识》开始,本指南已经更新过了4个版本。...随着中国医学界对于肿瘤相关性贫血（cancer related anemia,CRA）的逐渐重视,《肿瘤相关性贫血临床实践指南》也于今年更新到2015—2016版。从2011—2012版的《肿瘤相关性贫血临床实践中国专家共识》开始,本指南已经更新过了4个版本。从今年指南的更新之处可以看出,中国临床肿瘤学会（CSCO）组织对于输血的铁过载问题、促红细胞生成素（EPO）对于肿瘤细胞的刺激问题、展开更多
Diabetic retinopathy(DR) has been classically considered to be a microcirculatory disease of the retina caused by the deleterious metabolic effects of hyperglycemia per se and the metabolic pathways triggered by hyper...Diabetic retinopathy(DR) has been classically considered to be a microcirculatory disease of the retina caused by the deleterious metabolic effects of hyperglycemia per se and the metabolic pathways triggered by hyperglycemia.However,retinal neurodegeneration is already present before any microcirculatory abnormalities can be detected in ophthalmoscopic examination.In other words,retinal neurodegeneration is an early event in the pathogenesis of DR which predates and participates in the microcirculatory abnormalities that occur in DR.Therefore,the study of the mechanisms that lead to neurodegeneration will be essential to identify new therapeutic targets in the early stages of DR.Elevated levels of glutamate and the overexpression of the renin-angiotensin-system play an essential role in the neurodegenerative process that occurs in diabetic retina.Among neuroprotective factors,pigment epithelial derived factor,somatostatin and erythropoietin seem to be the most relevant and these will be considered in this review.Nevertheless,it should be noted that the balance between neurotoxic and neuroprotective factors rather than levels of neurotoxic factors alone will determine the presence or absence of retinal neurodegeneration in the diabetic eye.New strategies,based on either the delivery of neuroprotective agents or the blockade of neurotoxic factors,are currently being tested in experimental models and in clinical pilot studies.Whether these novel therapies will eventually supplement or prevent the need for laser photocoagulation or vitrectomy awaits the results of additional clinical research.展开更多
重组人促红细胞生成素(recombinant human erythropoietin,r Hu EPO)已成功用于治疗肾性贫血20余年,但由于其半衰期相对较短,需要频繁注射给药,降低了病人的依从性。近10年来多种新型促红细胞生成素(erythropoietin,EPO)制剂获批上市,...重组人促红细胞生成素(recombinant human erythropoietin,r Hu EPO)已成功用于治疗肾性贫血20余年,但由于其半衰期相对较短,需要频繁注射给药,降低了病人的依从性。近10年来多种新型促红细胞生成素(erythropoietin,EPO)制剂获批上市,促红细胞生成素仍是目前临床治疗肾性贫血的主要药物。目前长效促红细胞生成素的设计方法主要有增加糖基化位点、聚乙二醇修饰、构建融合蛋白和促红细胞生成素拟肽。本文综述了促红细胞生成素药物的发展、长效促红细胞生成素的设计方法及其新进展。展开更多
文摘随着中国医学界对于肿瘤相关性贫血（cancer related anemia,CRA）的逐渐重视,《肿瘤相关性贫血临床实践指南》也于今年更新到2015—2016版。从2011—2012版的《肿瘤相关性贫血临床实践中国专家共识》开始,本指南已经更新过了4个版本。从今年指南的更新之处可以看出,中国临床肿瘤学会（CSCO）组织对于输血的铁过载问题、促红细胞生成素（EPO）对于肿瘤细胞的刺激问题、
基金Supported by Grants from the Ministerio de Cienciae Innovacion,No.SAF2009-07408CIBER de Diabetesy Enfermedades Metabólicas Asociadas and Generaltitat de Catalunya,No. 2009SGR739
文摘Diabetic retinopathy(DR) has been classically considered to be a microcirculatory disease of the retina caused by the deleterious metabolic effects of hyperglycemia per se and the metabolic pathways triggered by hyperglycemia.However,retinal neurodegeneration is already present before any microcirculatory abnormalities can be detected in ophthalmoscopic examination.In other words,retinal neurodegeneration is an early event in the pathogenesis of DR which predates and participates in the microcirculatory abnormalities that occur in DR.Therefore,the study of the mechanisms that lead to neurodegeneration will be essential to identify new therapeutic targets in the early stages of DR.Elevated levels of glutamate and the overexpression of the renin-angiotensin-system play an essential role in the neurodegenerative process that occurs in diabetic retina.Among neuroprotective factors,pigment epithelial derived factor,somatostatin and erythropoietin seem to be the most relevant and these will be considered in this review.Nevertheless,it should be noted that the balance between neurotoxic and neuroprotective factors rather than levels of neurotoxic factors alone will determine the presence or absence of retinal neurodegeneration in the diabetic eye.New strategies,based on either the delivery of neuroprotective agents or the blockade of neurotoxic factors,are currently being tested in experimental models and in clinical pilot studies.Whether these novel therapies will eventually supplement or prevent the need for laser photocoagulation or vitrectomy awaits the results of additional clinical research.
文摘重组人促红细胞生成素(recombinant human erythropoietin,r Hu EPO)已成功用于治疗肾性贫血20余年,但由于其半衰期相对较短,需要频繁注射给药,降低了病人的依从性。近10年来多种新型促红细胞生成素(erythropoietin,EPO)制剂获批上市,促红细胞生成素仍是目前临床治疗肾性贫血的主要药物。目前长效促红细胞生成素的设计方法主要有增加糖基化位点、聚乙二醇修饰、构建融合蛋白和促红细胞生成素拟肽。本文综述了促红细胞生成素药物的发展、长效促红细胞生成素的设计方法及其新进展。
