中国神经再生研究(英文版) ›› 2016, Vol. 11 ›› Issue (3): 372-385.doi: 10.4103/1673-5374.179032

• 综述:周围神经损伤修复保护与再生 • 上一篇    下一篇

糖尿病及神经并发症治疗的新靶点:哺乳动物雷帕霉素靶蛋白

  

  • 收稿日期:2016-02-19 出版日期:2016-03-15 发布日期:2016-03-15

Novel nervous and multi-system regenerative therapeutic strategies for diabetes mellitus with mTOR

Kenneth Maiese   

  1. Cellular and Molecular Signaling, Newark, NJ, USA
  • Received:2016-02-19 Online:2016-03-15 Published:2016-03-15
  • Contact: Kenneth Maiese, M.D.,wntin75@yahoo.com.
  • Supported by:

    This research was supported by American Diabetes Association, American Heart Association, NIH NIEHS, NIH NIA, NIH NINDS, and NIH ARRA.

摘要:

糖尿病具有高发病率和死亡率。全球有近3.5亿糖尿病患者,这还不包括增长的易感人群中尚未确诊的人口数量。糖尿病导致包括认知功能障碍,视网膜病变,神经精神疾病,脑缺血,及外周神经变性等多种中枢和周围神经系统并发症。尽管多种糖尿病治疗策略正在研制中,营养因子,Wnt信号,WNT1诱导信号通路蛋白1,及干细胞治疗被视为令人兴奋的有效治疗方法。它们可以抑制氧化应激的细胞机制,细胞凋亡,自体吞噬糖尿病神经元损伤。胰岛素样生长因子-1,成纤维细胞生长因子,表皮生长因子,促红细胞生成素的途径可以支配的葡萄糖稳态和密切依赖于Wnt信号涉及Wnt1和WISP1促进对干细胞增殖的控制,伤口修复,认知衰退,β细胞增殖,血管再生,和程序性细胞死亡。最终,通过mTOR和AMPK途径驱动Wnt信号的细胞代谢。

Abstract:

Throughout the globe, diabetes mellitus (DM) is increasing in incidence with limited therapies presently available to prevent or resolve the significant complications of this disorder. DM impacts multiple organs and affects all components of the central and peripheral nervous systems that can range from dementia to diabetic neuropathy. The mechanistic target of rapamycin (mTOR) is a promising agent for the development of novel regenerative strategies for the treatment of DM. mTOR and its related signaling pathways impact multiple metabolic parameters that include cellular metabolic homeostasis, insulin resistance, insulin secretion, stem cell proliferation and differentiation, pancreatic β-cell function, and programmed cell death with apoptosis and autophagy. mTOR is central element for the protein complexes mTOR Complex 1 (mTORC1) and mTOR Complex 2 (mTORC2) and is a critical component for a number of signaling pathways that involve phosphoinositide 3-kinase (PI 3-K), protein kinase B (Akt), AMP activated protein kinase (AMPK), silent mating type information regulation 2 homolog 1 (Saccharomyces cerevisiae) (SIRT1), Wnt1 inducible signaling pathway protein 1 (WISP1), and growth factors. As a result, mTOR represents an exciting target to offer new clinical avenues for the treatment of DM and the complications of this disease. Future studies directed to elucidate the delicate balance mTOR holds over cellular metabolism and the impact of its broad signaling pathways should foster the translation of these targets into effective clinical regimens for DM.