The ketogenic diet in a pill: is this possible?
The ketogenic diet in a pill: is this possible?
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药丸中的生酮饮食：这可能吗？
DOI：
10.1111/j.1528-1167.2008.01857.x
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发表时间：
2008-11
期刊：
影响因子：
5.6
通讯作者：
Sankar R
中科院分区：
文献类型：
--
作者：
Rho JM;Sankar R
在过去的十年中，在了解生酮饮食（KD）作用机制方面取得了很大进展。从KD引起的复杂的全身和代谢变化中出现了创新的假设，试图将生化适应与其临床效果联系起来。尽管取得了这些进展，但KD如何工作的基本问题仍然像以往一样难以捉摸。目前，尚不清楚迄今提出的许多潜在机制中的哪些与KD的临床效应直接相关。这些众多的假设不太可能统一为一个单一的机制（或最终的共同途径）。然而，依次考虑这些假定机制中的每一个并提出以下问题可能是有益的：如果所讨论的机制或靶点是KD抗惊厥疗效的关键决定因素，那么已知基于该机制的类似干预是否会产生类似的效果？也许回答这个问题的每一个机械的猜测可能有助于证实（或无效）的特定假设。KD可以包装成药丸吗？目前，答案很可能是“不”。我们还没有发现一种“灵丹妙药”，完全反映了KD的抗惊厥（和潜在的神经保护）作用。然而，如果没有对KD引起的复杂代谢之谜的机制因素有更清楚的了解，我们就只能靠经验观察，并好奇地想知道高脂肪饮食如何产生如此深远的临床影响。
Over the past decade, much progress has been made in understanding the mechanisms of ketogenic diet (KD) action. From the complex systemic and metabolic changes induced by the KD have emerged innovative hypotheses attempting to link biochemical adaptations to its clinical effects. Despite such developments, the fundamental question of how the KD works remains as elusive as ever. At present, it is unclear which of many potential mechanisms proposed thus far are directly relevant to the clinical effects of the KD. It is unlikely that these numerous hypotheses can be unified into a single mechanism (or a final common pathway). Nevertheless, it may be instructive to consider each of these putative mechanisms in turn and ask the following question: If the mechanism or target in question is a critical determinant of the anticonvulsant efficacy of the KD, then would a similar intervention known to be based on that mechanism yield a comparable effect? Perhaps answering this question for each mechanistic speculation might help substantiate (or invalidate) that particular hypothesis. Can the KD be packaged into a pill? At present, the answer is likely “no.” We have yet to discover a “magic bullet” that completely mirrors the anticonvulsant (and potential neuroprotective) effects of the KD. However, without a clearer understanding of the mechanistic elements comprising the complex metabolic puzzle posed by the KD, we would be left only with empiric observations, and to wonder curiously how a high-fat diet can exert such profound clinical effects.
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