Metformin: A Potential Therapeutic Tool for Rheumatologists.
Metformin: A Potential Therapeutic Tool for Rheumatologists.
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二甲双胍：风湿病学家的潜在治疗工具。
DOI：
10.3390/ph13090234
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发表时间：
2020-09-04
期刊：
影响因子：
--
通讯作者：
Sasso FC
中科院分区：
文献类型：
--
作者：
Salvatore T;Pafundi PC;Galiero R;Gjeloshi K;Masini F;Acierno C;Di Martino A;Albanese G;Alfano M;Rinaldi L;Sasso FC
二甲双胍是一种口服降糖药物，广泛用于治疗2型糖尿病，通过间接激活5 '腺苷单磷酸活化蛋白激酶（AMPK）起作用。事实上，已经积累的证据表明，AMPK具有一种有趣的抗炎活性，主要通过多种机制介导，如抑制细胞因子刺激的核因子-κB （NF-κB）和下调Janus激酶/信号转导和转录激活因子（JAK/STAT）信号通路。此外，AMPK在T淋巴细胞和其他先天免疫系统的关键细胞的调节中起着重要作用。目前对AMPK效应的理解为二甲双胍在自身免疫和炎症条件管理中的重新应用提供了强有力的理论依据。几项研究表明，二甲双胍对动物和人类的风湿性疾病，特别是类风湿关节炎都有有益的作用。不幸的是，尽管数据庞大而引人注目，但它们几乎完全来自实验研究，只有少数来自临床试验。由于缺乏前瞻性安慰剂对照试验的支持，二甲双胍不允许进入风湿病学家的治疗方案。然而，很大比例的风湿病患者目前可以从二甲双胍中获益，例如伴有肥胖和2型糖尿病的患者，这两种疾病与类风湿关节炎、骨关节炎和痛风密切相关，以及类固醇治疗后继发的糖尿病患者。
Metformin is an oral antihyperglycemic drug widely used to treat type 2 diabetes, acting via indirect activation of 5′ Adenosine Monophosphate-activated Protein Kinase (AMPK). Actually, evidence has accumulated of an intriguing anti-inflammatory activity, mainly mediated by AMPK through a variety of mechanisms such as the inhibition of cytokine-stimulated Nuclear Factor-κB (NF-κB) and the downregulation of the Janus Kinase/Signal Transducer and Activator of Transcription (JAK/STAT) signaling pathways. Moreover, AMPK plays an important role in the modulation of T lymphocytes and other pivotal cells of the innate immune system. The current understanding of these AMPK effects provides a strong rationale for metformin repurposing in the management of autoimmune and inflammatory conditions. Several studies demonstrated metformin’s beneficial effects on both animal and human rheumatologic diseases, especially on rheumatoid arthritis. Unfortunately, even though data are large and remarkable, they almost exclusively come from experimental investigations with only a few from clinical trials. The lack of support from prospective placebo-controlled trials does not allow metformin to enter the therapeutic repertoire of rheumatologists. However, a large proportion of rheumatologic patients can currently benefit from metformin, such as those with concomitant obesity and type 2 diabetes, two conditions strongly associated with rheumatoid arthritis, osteoarthritis, and gout, as well as those with diabetes secondary to steroid therapy.
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DOI：
10.1084/jem.20130323
发表时间：
2013-11-18
期刊：
The Journal of experimental medicine
影响因子：
--
作者：
Deenick EK;Avery DT;Chan A;Berglund LJ;Ives ML;Moens L;Stoddard JL;Bustamante J;Boisson-Dupuis S;Tsumura M;Kobayashi M;Arkwright PD;Averbuch D;Engelhard D;Roesler J;Peake J;Wong M;Adelstein S;Choo S;Smart JM;French MA;Fulcher DA;Cook MC;Picard C;Durandy A;Klein C;Holland SM;Uzel G;Casanova JL;Ma CS;Tangye SG
通讯作者：
Tangye SG
影响因子：
4.8
作者：
Harris, James;Hartman, Michelle;Lavelle, Ed C.
通讯作者：
Lavelle, Ed C.
影响因子：
--
作者：
Dessein, Patrick H.;Joffe, Barry I.
通讯作者：
Joffe, Barry I.
影响因子：
27.4
作者：
Bruyn, G. A. W.;Tate, G.;van Riel, P. L. C.
通讯作者：
van Riel, P. L. C.
影响因子：
27.4
作者：
Bruderer, Saskia G.;Bodmer, Michael;Meier, Christoph R.
通讯作者：
Meier, Christoph R.