Metabolomics: Impact of comorbidities and inflammation on sickness behaviors for individuals with chronic wounds.
Metabolomics: Impact of comorbidities and inflammation on sickness behaviors for individuals with chronic wounds.
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DOI：
10.1089/wound.2020.1215
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发表时间：
2020-07
影响因子：
4.9
通讯作者：
Junglyun Kim;G. Yang;D. Lyon;D. Kelly;J. Stechmiller
中科院分区：
文献类型：
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作者：
Junglyun Kim;G. Yang;D. Lyon;D. Kelly;J. Stechmiller
美国约有650万人患有慢性伤口。慢性伤口人群通常年龄较大，并且具有许多与炎症相关的合并症。除了经历伤口相关的疼痛，患有慢性伤口的个体通常会经历多种并发的心理神经症状，如疲劳和抑郁，这会延迟伤口愈合。然而，这些令人痛苦的症状在这一人群中相对被忽视，尽管它们对发病率的不利影响在其他慢性病人群中得到了充分的证实。最新进展：炎症参与多种途径，激活脑内皮细胞和先天免疫细胞，释放促炎细胞因子，产生多种症状，称为疾病行为。犬尿氨酸途径及其代谢物的基于炎症的激活是与慢性疾病相关的机制。关键问题虽然已经确定了假定的体液和神经元途径，在慢性伤口患者的疾病行为所涉及的具体代谢变化仍然不清楚。为了改善慢性伤口人群的健康结果，临床医生需要更好地了解疾病行为的机制，以提供适当的治疗。未来的方向本文介绍了一个综合的研究调查炎症，代谢途径和疾病行为之间的关联，在多种慢性疾病。提出了一个理论框架，提出了慢性伤口人群的疾病行为的机制。通过介导免疫系统应答，犬尿氨酸途径中失调的代谢物可能在慢性炎症状况中的疾病行为中起重要作用。该框架可以指导研究人员开发新的治疗方法，以减少慢性伤口人群的疾病负担。
SIGNIFICANCE Approximately 6.5 million people in the United States suffer from chronic wounds. The chronic wound population is typically older and is characterized by a number of comorbidities associated with inflammation. In addition to experiencing wound-related pain, individuals with chronic wounds commonly experience multiple concurrent psychoneurological symptoms such as fatigue and depression, which delay wound healing. However, these distressing symptoms have been relatively overlooked in this population, although their adverse effects on morbidity are well-established in other chronic disease populations. Recent Advances: Inflammation is involved in multiple pathways which activate brain endothelial and innate immune cells that release pro-inflammatory cytokines, which have been produce multiple symptoms known as sickness behaviors. Inflammation-based activation of the kynurenine pathway and its metabolites is a mechanism associated with chronic illnesses. CRITICAL ISSUES Although putative humoral and neuronal routes have been identified, the specific metabolic variations involved in sickness behaviors in chronic wound patients remains unclear. To improve health outcomes in the chronic wound population, clinicians need to have better understanding of the mechanisms underlying sickness behaviors to provide appropriate treatments. FUTURE DIRECTIONS This paper presents a synthesis of studies investigating associations between inflammation, metabolic pathways, and sickness behaviors in multiple chronic diseases. The presentation of a theoretical framework proposes a mechanism underlying sickness behaviors in the chronic wound population. By mediating the immune system response, dysregulated metabolites in the kynurenine pathway may play an important role in sickness behaviors in chronic inflammatory conditions. This framework may guide researchers in developing new treatments to reduce the disease burden in the chronic wound population.