非必需氨基酸在老年患者中并非非必需:对颌面伤口愈合和骨修复的影响。

IF 2 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
Seong-Gon Kim
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引用次数: 0

摘要

背景:非必需氨基酸(NEAAs)传统上被认为是可有可无的,因为它们可以由葡萄糖衍生的中间体内源性合成。然而,新出现的证据表明,衰老组织的新生NEAA生物合成能力下降,在手术或骨折修复等应激时期,这些分子中的一些是有条件必需的。主体:在颅颌面领域,骨和软组织再生必须在骨质疏松、多病和限制口服摄入的环境中进行,NEAA供应不足可能导致愈合延迟、伤口开裂和感染风险增加。这篇叙述性综述整合了生化、临床前和临床数据,以绘制出年龄依赖性的变化图,其中包括了血清氨酸/甘氨酸、谷氨酰胺/谷氨酸、精氨酸/瓜氨酸、半胱氨酸/反式硫酸和丙氨酸循环,研究了它们对成骨和粘膜愈合的影响,并评估了恢复NEAA充足性的营养或药理策略。特别关注丝氨酸-一碳代谢,肠-肾精氨酸轴和氧化还原敏感半胱氨酸途径,所有这些都与胶原沉积,成骨细胞分化和免疫调节密切相关。结论:我们的结论是,主动优化NEAA状态——通过靶向补充或代谢激活——是一种低风险、生物学上合理的辅助手段,可以提高老年颌面患者的术后预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Nonessential amino acid is not nonessential in geriatric patients: implications for maxillofacial wound healing and bone repair.

Background: Nonessential amino acids (NEAAs) are traditionally regarded as dispensable because they can be synthesized endogenously from glucose-derived intermediates. Emerging evidence, however, shows that the capacity for de novo NEAA biosynthesis declines in aged tissues, rendering several of these molecules conditionally essential during periods of stress such as surgery or fracture repair.

Main body: In the cranio-maxillofacial arena - where bone and soft-tissue regeneration must occur in an environment already compromised by osteoporosis, multimorbidity, and restricted oral intake - insufficient NEAA supply may translate into delayed union, wound dehiscence, and heightened infection risk. This narrative review integrates biochemical, preclinical, and clinical data to map age-dependent changes in the serine/glycine, glutamine/glutamate, arginine/citrulline, cysteine/trans-sulfuration, and alanine cycles, examines their impact on osteogenesis and mucosal healing, and evaluates nutritional or pharmacological strategies to restore NEAA sufficiency. Particular attention is paid to serine-one-carbon metabolism, the intestinal-renal arginine axis, and redox-sensitive cysteine pathways, all of which are intimately linked to collagen deposition, osteoblast differentiation, and immune modulation.

Conclusion: We conclude that proactive optimization of NEAA status - through targeted supplementation or metabolic activation - represents a low-risk, biologically rational adjunct to enhance postoperative outcomes in geriatric maxillofacial patients.

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来源期刊
Maxillofacial Plastic and Reconstructive Surgery
Maxillofacial Plastic and Reconstructive Surgery DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
4.30
自引率
13.00%
发文量
37
审稿时长
13 weeks
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